Pulmonary Hypertension

​Treatments for pulmonary hypertension, such as medications and surgery, are aimed at relieving symptoms, improving quality of life, and slowing down the disease progression. Doctors will also treat the underlying disease for patients whose pulmonary hypertension is caused by another medical condition. In addition, patients will need to change their lifestyle when their symptoms become worsen or when their daily activities are limited

Pharmacotherapy

There are several types of medications available for the treatment of pulmonary hypertension. They are mainly formulated to reduce the workload of the heart and improve blood flow through the lung vessels.

Doctors may prescribe the medications based on the patients’ severity of the condition and how well they respond to treatment.

The medications typically prescribed for pulmonary hypertension include:

• Anticoagulants to prevent blood clots from forming in the lung vessels
• Calcium channel blockers to reduce constriction in the pulmonary vessels
• Diuretics to reduce the volume of blood the heart needs to pump
• Digoxin to help the heart pump blood more effectively
• Inhaled oxygen to reduce shortness of breath
• Endothelin receptor antagonists (ERAs) such as bosentan and macitentan to suppress the harmful effects of endothelin, a hormone that helps to control blood flow and cell growth in blood vessels
• Phosphodiesterase-5 inhibitors (PDEI), such as sildenafil and tadalafil, to relax and reduce abnormal cell growth in blood vessels
• Prostacyclins, including inhaled iloprost and epoprostenol, to relax the blood vessels, lower abnormal cell growth and help prevent blood clots
  
  

Cardiovascular procedures and surgeries

Doctors may recommend procedural or surgical treatment for pulmonary hypertension patients based on many factors.



These procedures and surgeries include:

• Pulmonary endarterectomy: This may be considered as treatment for chronic thromboembolic pulmonary hypertension (CTEPH). It involves removing blood clots from the pulmonary arteries, to restore blood flow to the lungs.
• Balloon pulmonary angioplasty: This is a non-surgical option for patients with CTEPH who are not suitable for pulmonary endarterectomy.
• Atrial septostomy: This procedure involves creating a hole between the top chambers of the heart to reduce the effects of high lung pressure in overworking the right side of the heart.
• Lung or heart and lung transplantation: Patients who do not respond to standard treatments may be considered for heart and/or lung transplantation. While this major surgery can be life-saving, the availability of donor organs is extremely limited.

Lifestyle modifications

Pulmonary hypertension is a lifelong condition, thus patients with the condition may need to modify their living space and daily activities when symptoms worsen. They may also need assistance around the house due to their limitations.

Lifestyle modifications for pulmonary hypertension patients include:

• Finding resources to ease daily and weekly house chores
• Limiting climbing of stairs
• Modifying showers and baths with easily reachable faucets and shower racks (for soap, shampoo, etc.)
• Making laundry areas more accessible
• Rearranging kitchen tools for easy access
• Managing the daily needs of children, from transportation to school and preparation of meals
• Arranging for regular and emergency child care
• Securing handicapped parking
• Managing family outings and home activities